Ten of Louisiana’s 12 prison physicians have had their medical licenses restricted or suspended at some point. The state’s incarcerated people have nowhere else to turn during a pandemic.
For his $8,000 in methamphetamine purchases made in a Home Depot parking lot with the intent to distribute, Louisiana doctor Randy Lavespere was found guilty in 2006. In addition to serving two years in prison, his license as a physician was revoked. Although he was forbidden from practicing medicine as a result of his criminal conviction, he was permitted to treat patients in Louisiana state prisons despite this.
A month after the Louisiana State Medical Board reinstated his medical license and placed him on indefinite probation, Lavespere was hired as a physician at Louisiana State Penitentiary, the country’s largest maximum-security prison, better known as Angola because of the plantation on which it was built. In November 2014, fewer than three weeks after his license was completely reinstated, Lavespere ascended through the ranks of the prison’s medical staff to become the facility’s medical director. He was reassigned to the position of chief medical officer at the Louisiana Department of Corrections earlier this year.
Medical licenses have been restricted or suspended for ten of the 12 physicians employed by the Louisiana Department of Corrections. According to compliance orders issued by the Louisiana State Board of Medical Examiners, many were reprimanded for unlawfully dispensing medications, two committed fraud, one participated in sexual misconduct, and another former medical director pled guilty to possession of child pornography.
Patients in state prisons typically have health issues because of the surroundings they live in and the fact that they are unable to pick their own doctors. In spite of the fact that both the National Commission on Correctional Health Care and the American College of Correctional Physicians (previously the Society of Correctional Physicians) oppose the practice of hiring physicians with licensure, at least three Louisiana doctors began working in state prisons before their licenses were fully restored. The medical director at Rayburn Correctional Center is one such example.
After his release from Angola last month, an anonymous former prisoner tells the New York Times that “the doctors they hired there are there serving a sentence of their own.”
The Louisiana State Board of Medical Examiners enables physicians forbidden from practicing medicine in most hospitals to work in specific “institutional” settings, such as prisons. This has led to a clustering of doctors with disciplinary records at prisons throughout the state.
According to an email from a department representative, “their licensing status must meet the Louisiana Medical Boards’ standards for working in a correctional setting” before doctors may be considered for prison positions. According to him, jail inmates are treated by state-employed doctors who give “professional and responsive care.”
However, interviews with former inmates of Angola, a Tulane University doctor who frequently sees patients from Louisiana prisons, a Louisiana lawyer who has represented many clients in Louisiana prisons, and three correctional medicine experts who conducted a comprehensive review of Angola’s medical practices in 2016 as part of a lawsuit against the prison reveal that medical neglect has flourished under their watchful eyes.
LSP detainees are at danger of serious injury because to a lack of sufficient healthcare, according to a study of the system. Medical care at Louisiana State Penitentiary is the worst we have ever seen in our combined 60 years of expertise in correctional medicine.
According to a federal court ruling last month, the Louisiana Department of Corrections had violated the Eighth Amendment of the United States Constitution which prohibits “cruel and unusual punishment” and was neglecting to give proper medical treatment. The decision has been challenged by the Department of Corrections.
It is been revealed that a man who was imprisoned at Angola was infected from his lower back to his buttocks and even to the bottom of his penis. Medical workers overlooked the needs of two formerly jailed persons who said in interviews that they and other patients on the hospital ward had been denied required procedures, detained in unclean circumstances, and treated as if they were lying about their requirements.
If a person is imprisoned, the State Board of Medical Examiners says it is “willing to protect the health, safety, and welfare of its citizens.” Louisiana Department of Corrections and Public Safety has assured that convicts receive subpar care by appointing these doctors.
Despite the experts’ findings, the Department of Corrections refused to respond, citing current litigation.
More than 30,000 inmates detained in the state’s jails are still being cared for by doctors who have been barred from practicing in the community because of their professional records. Medical director Dan LaFleur was sentenced to six months in federal prison in 2016 after pleading guilty to possession of illicit drugs. Previously, in 2013, he had been sentenced to six months of license suspension and seven years of probation. The limitations were abolished in December of last year.
Those infected with the coronavirus at Camp J, a former solitary confinement wing that was restored in the spring of this year, were sent there in March 2020 when the virus spread throughout Angola. A temporary restraining order was soon filed against the facility by a group of inmates.
When quarantine is violated, there are no choices for social distance, and those in quarantine are not given masks to wear, the motion filed in April 2020 states. When it comes to keeping people safe from disease, “numerous locations report that there is either no soap available or that there is insufficient soap.”
In the complaint, the camp had mildew, poor ventilation, floods, and malfunctioning door locks, according to the document.
The individual who talked about his time at Camp J has now been released. It was at this hospital that he developed severe COVID and pneumonia at the same time and was unable to take a deep breath without experiencing shooting pain in his ribs. He also had difficulty walking even short distances and was forced to yell for help, waiting as long as 30 minutes before anyone came and checked on him.
People who are ill are no longer held in the camp, according to a Department of Corrections official, who refused the emergency move to shut the building.
According to an attorney who works with inmates in the state’s jails, Mercedes Montagnes, several institutions have failed to provide necessary safety equipment, delayed medical care, and prohibited jailed persons from socially isolating themselves. According to the Marshall Project, more than 3,200 inmates in California’s jails have been diagnosed with COVID, and 36 have died as a result. This places the state’s death toll from coronavirus disease as the nation’s 12th highest.
In Louisiana, where imprisonment rates are among the highest in the country, jail conditions have long been the subject of public criticism. According to the Bureau of Justice Statistics, which includes both federal and state prisons but excludes executions, Louisiana had the nation’s highest rate of inmate fatalities from 2001 to 2013, with an average of around 481 deaths per 100,000 inmates.
The medical inspectors, Michael Puisis, Madeleine LaMarre, and Susi Vassallo, noted in their report that “given our record reviews of deaths, it is our opinion that there are many preventable deaths at LSP that explain this extraordinary prisoner mortality rate.” Every physician working at Angola at the time of the 2016 study had had their license revoked or suspended at some point.
In addition to Lavespere, five doctors were barred from dispensing banned medications by the Board of Pharmacy. Elayn Hunt Correctional Center physician Hal David MacMurdo was ordered to abstain from all drugs and alcohol after rumors surfaced that he had been drinking while on duty. After being accused with possession and trafficking of methamphetamine and cannabis, Louisiana Correctional Institute for Women’s medical director, John Prejean, had his medical license suspended until he completed a drug treatment program. Part-time Angola physician Kasimu Moody illegally prescribed banned medications. One case of healthcare fraud was filed against Rayburn Prison’s medical director, Robert Cleveland, who was subsequently found to be dispensing opioids from his house and vehicle; his license was suspended, and he is currently on probation. Before moving to Angola, Linda Bunch worked as the medical director at David Wade Correctional Center, where she was convicted of being part of a conspiracy to import and distribute human growth hormone.
Mortgage fraud was found to be the crime of Daniel Crook, an associate medical director at David Wade. (Last year, Louisiana Governor John Bel Edwards awarded him clemency.)
As per the terms of his consent order, Dixon Prison’s medical director Paul Toce participated in “professional sexual misconduct” by prescribing drugs for himself and members of his family without keeping necessary medical records. Convicted child sex abuser Casey McVea, a former medical director at Raymond Laborde Correctional Center, was sentenced to two years in prison for possessing child pornography. Last year, he died of COVID-19 after doing time in federal prison and working at Raymond Laborde.
Dr. Jonathan Roundtree, who is currently the medical director of Elayn Hunt, was put on probation in 1993 for distributing restricted drugs “unlawfully and imprudently.”
Francis Brauner, now 55, was transported to Angola in 2005 after fracturing his back while laboring in the fields at Dixon Correctional Institute. Roundtree and MacMurdo were responsible for his care.
Brauner arrived in Angola disabled from the waist down, yet he was still regarded a danger to himself and kept in a room by himself. Brauner claimed in a recent interview that he suffered a sore on his tailbone because he was not instructed that he needed to turn himself in the bed. It developed into a serious illness and spread to his testicles and buttocks.
A “bad infection” caused Brauner’s rectum to open, allowing drainage tubes to be inserted, he claimed. “It was—it was—it was bad.” When I was in the hospital, they did not believe I would make it.
A few weeks at the Earl K. Long hospital followed before being discharged and sent back to Angola with his mother and sister. According to him, the illness did not go away for more than a year.
A lawsuit was launched against Roundtree and MacMurdo, former Angola medical director Jason Collins, and two assistant wardens by Brauner after the event, saying that the physicians had been purposely insensitive to Brauner’s needs.
Among other things, Brauner claimed that he was refused a sliding board and specific cushions, that the showers were unclean, and that the personnel failed to give enough turning and range of motion therapy.
Fly traps hung over men’s heads as they tried to eat in the hospital wing, excrement in the showers, blood all over the floor, no privacy while talking to physicians, and a general distrust between patients and the medical personnel were all recounted by Brauner.
Brauner’s lawsuit was rejected in 2015 when a court ruled that his accusations of “deliberate indifference” did not meet the high standards required by the law. Response to Brauner’s complaint was given by the Department of Corrections, who referenced that ruling.
A practice that places a disproportionate emphasis on doctors with disciplinary histories means that even after their medical licenses have been fully restored for the majority of Louisiana’s prison doctors, they face the same challenges as people returning from prison: being left to their own devices without the institutionalized guidance or structure they so desperately need.
“If the prison wanted to have one person in the facility who was in that posture, they had a vibrant and wholesome plan to support that person and make sure that they were doing the monitoring and training that they needed in order to fulfill the mission of them being reintegrated into the medical team, I think that that could be fine,” Montagnes, the lawyer who has worked with Brauner and others in the state. Here, the evidence is just the opposite.
Instead, Montagnes said, while the state has repeatedly hired doctors with license restrictions, there has been “no evidence of monitoring, no evidence of support, no desire to see any sort of services be provided to these physicians in order for them to improve their standard of care.”
Due to pending legal proceedings, the Department of Corrections refused to comment on Montagnes’ evaluation.
Angola was the venue of Puisis and LaMarre’s investigation for a 2015 lawsuit, during which time they looked through records and spoke with inmates as well as staff members. As they wrote in their report, prison medical directors are supposed to oversee and organize all medical care in their facilities and supervise staff, but when Lavespere was medical director at Angola, he “apparently [did] not perform many of these typical functions.”
Experts determined that Lavespere, like the other physicians, provided some clinical treatment in the hospital wing, but he did not supervise EMT staff, participate in “quality improvement efforts,” or conduct patient death reports. There were no specifics on how much time he spent administering the medical program and no information on the prison’s medical budget in his deposition in 2016, according to the analysis.
To get out of labor, jailed persons often make up ailments or diseases they do not have, according to Lavespere.
You know, it is the hardest issue,” he remarked in his deposition. They do not necessarily want to become healthy in Angola because they have to do things if they get well.”
As a result of the current dispute, a Government of Corrections representative declined to comment on whether or not the department accepts Lavespere’s view.
For the patients whom the jail physicians serve, poor medical care has had terrible implications.
Apparently, a healthy Angolan guy was disabled in February 2010 after sustaining a neck injury while playing football. At the time of the inspections in 2016, he was residing in the prison’s hospital wing and informed the inspectors that his trachea tube had become blocked and he was having difficulty breathing and that he was kept in an isolation cell with no call system.
“The solid door is locked and the nurses cannot hear him even if he screams,” the report stated. According to him, he was bathed and turned by inmate orderlies rather than medical professionals, and no one ever woke him up if he was sleeping at the time of breakfast being given, according to the inspectors. When he was interviewed, he indicated it had been two weeks since he had cleaned his hair, and he was not provided any kind of vocational or recreational treatment.
AIDS patients were given medicine for four days after they died, according to medical documents reviewed in the review. This is evidence of inaccuracies in the prison’s medication records, according to the medical experts.
Lavespere was elevated to acting medical director last year, notwithstanding the Angola findings of 2016. Permanently, he accepted the position on January 1, 2021.
Tulane University Hospital treats some of the most critically ill and injured inmates from state jails. Anjali Niyogi, one of the hospital’s doctors, that many of the inmates she treats for heart failure and lung illness should have been brought in sooner. It is too late for the majority of cancer patients, she added, because their disease has already spread by the time she meets them, despite the fact that patients told her they had complained to prison physicians for years about their need for care.
At that point, she explained, “there is nothing we can do to regain function of the legs or to really cure the cancer” if a patient has lost the use of their legs and arrives at the hospital for an MRI. “We see that there is just metastatic disease throughout the spine at that point.”
According to the Department of Corrections, they could neither confirm nor refute Niyogi’s claims and claimed that the state had not been informed of any specific concern by her.
According to the DOC’s spokeswoman, “the DOC makes every effort to transport offenders to tertiary hospitals in a timely manner” when more advanced treatment is needed. “It is our goal to deliver the standard of care in each case.”
Long before the coronavirus was known, health hazards in Louisiana’s jails were already high. When the pandemic broke out, there were few places in the country worse to be than a Louisiana prison.
Since COVID does not provide transportation for out-of-state appointments or even telemedicine centers for virtual visits, many of the patients Niyogi said she was seeing with chronic diseases or conditions that required specialists were left untreated—and their care was solely provided by prison physicians.